CareCaliRaya Ltd T/A Apollo Care South Liverpool

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

This is the first assessment for this newly registered service. This key question has been rated requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

The provider was in breach of legal regulation in relation to people’s safe care and treatment.

This service scored 54 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always make sure people’s care and treatment was effective because people’s needs, wishes and preferences had not always been adequately assessed. This meant staff did not always have access to up-to-date information on people’s current needs were or guidance on how to support people effectively. For example, we found assessments of people’s needs in areas such as falls, skin integrity, nutrition and other risks specific to the individual were not always completed.

People and their relatives told us they had been involved in discussions about their or their loved one’s care when they first started receiving support. However, when reviews took place, we found a lack of detail regarding what was discussed and the outcome of the reviews. The shortfalls identified with the completeness of records placed people at risk of ineffective care which did not meet their needs, wishes or preferences.

The provider did not always plan and deliver people’s care and treatment with them in line with legislation and current evidence-based good practice and standards.

Some people’s assessments and care plans did not reflect best practice guidance issued by The National Institute of Health and Social Care Excellence (NICE) in areas such as skin integrity.

The provider did not always follow good practice guidelines issued by NICE or CQC for the safe management of medicines. For example, medication care plans and medication administration records were not always well maintained and did not always reflect the required medicines support.

The provider did not have any adequate auditing processes in place to assess and monitor the delivery of care to ensure it adhered to recognised standards and relevant legislation.

The provider understood their responsibility to work collaboratively with external stakeholders to ensure they had the information deliver to people’s care, treatment and support effectively. However, records showed people’s needs and risks had not always been adequately assessed to enable full and accurate information to be shared with other teams or other professionals should an emergency occur. For example, medicine records had not been properly maintained to enable professionals to be assured people had received their prescribed medicines when they needed them.

Where people were supported by familiar staff who knew them well, we found this promoted opportunities for good verbal communication with the person’s GP and local district nurse teams who supported their health. The provider took part in regular meetings with external health professionals and information was shared regarding people’s care and treatment.

An external health professional told us the provider worked with them well to support the health and wellbeing of people. They told us, “Staff keep the senior nurses updated with any issues they have in relation to our patients to ensure patient safety. They will also contact district nurses if they have any concerns in relation to uncontrolled or new symptoms."

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

People’s visit records provided a detailed account of the care delivered and showed people received the necessary support from staff to stay well. Records showed people who required support with their nutrition and hydration were supported appropriately, with snacks and drinks left for them in between visits.

People and their relatives told us staff supported them to be independent and helped them with the daily living tasks they needed help with. A relative told us, “We would lost be without them, the [staff] have changed [Person’s] life in good ways."

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure records demonstrated positive outcomes and consistency in care, or that they met the expectations of people themselves. For example, where people had risks relating to skin integrity, we found shortfalls in the auditing of care notes which meant the provider had not identified skin checks had not been completed for an extended period. We found no evidence of harm; however, the lack of effective monitoring increased the risk of this person having a poor health outcome.

The provider had a policy to guide staff on how to assess people’s capacity to make decisions in accordance with the Mental Capacity Act. However, this guidance was not always followed. Where there were concerns about a person’s capacity to consent, we did not always find evidence a detailed assessment of their capacity had been undertaken. This aspect of service delivery required improvement.

Staff understood the importance of gaining consent prior to supporting people with care. A staff member told us, “I always gain consent, I talk though what I would like to do and ask them if that is ok.” People’s feedback and care notes confirmed this was taking place.